Pre-Task Safety Assessment
Complete this assessment to identify hazards and ensure all safety measures are in place before starting your task.
Name of Person Completing Assessment
*
First Name
Last Name
Task Title or Description
*
Task Location
*
Date of Assessment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Identify all potential hazards associated with this task
*
Slips, trips, and falls
Working at height
Electrical hazards
Manual handling
Hazardous substances
Noise or vibration
Other
Select the control measures that will be implemented
*
Personal protective equipment (PPE)
Safety signage
Isolation of energy sources
Supervision or monitoring
Barriers or guards
Other
Have all team members been briefed about the hazards and control measures?
*
Yes
No
Additional comments or observations
Submit Assessment
Should be Empty: